Methods

Using a randomized crossover design, 11 regional paramedicine students and graduates (mean±SD age= 23±2 years) completed two, 20-minute high-fidelity simulations that included cardiopulmonary resuscitation (CPR) immediately after either an acute bout of occupational physical activity (OPA) or a rest period (REST). Heart rate, respiratory rate, and mean arterial pressure were measured throughout. Clinical performance was scored using the Global Rating Score and a patient care record. Measures of CPR efficacy were recorded in the manikin.

Results

There were no significant differences in Global Rating Score (P= 0.07, ES= 0.03) or CPR efficacy between conditions. Patient care record accuracy was higher after the OPA versus REST simulations (mean±SD= 61.8±12.6% vs. 55.5±12.0%, P= 0.03, ES= 0.5). Mean heart rate was higher during OPA simulations versus REST simulations (121±14 vs. 84±9 beats per minute, P< 0.01, ES= 3.1), as was mean respiratory rate (19±3 vs. 16±3 breaths per minute, P< 0.01, ES= 1.0). Mean arterial pressure was higher for OPA versus REST at simulation start (105±11.3 vs. 95.8±11.8 mm Hg, P= 0.01, Effect Size= 0.8), although not different after simulation.

Conclusions

Paramedicine students including recent graduates performed as well, or better, in a simulated clinical scenario immediately after occupation-specific acute physical exertion compared with a REST, despite higher physiological exertion. Whether this is the case for more experienced but potentially less physically fit paramedics in the workforce warrants investigation.